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Was it something that you felt needed to be reported? Some participants reported using oil-based lubricants such as jojoba or baby oil and Vaseline; Remicaine gel which contains lidocaine ; plain yogurt; and saliva. Belgian MSM rated the lack of lubrication and of anal foreplay as the most important factors predicting pain during RAI Vansintejan et al. The epidemiology of rape and sexual coercion in South Africa: There are some additional limitations inherent in the method of assessment and the assessments that were utilized.

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The story shared by Tlotliso exemplified the potential vulnerability of MSM in their first sexual encounters, which could be amplified by the need or desire for secrecy about engaging in same-sex sexual behavior. Gendered power dynamics appear to play an important role, but further study is needed to better understand the way in which such dynamics shape sexual encounters and relationships. Capacitating health care workers should include skills-building around non-stigmatizing clinical care of MSM and strengthening practices around patient confidentiality to avoid, among other things, involuntary disclosure of same-sex sexual behaviors or sexual minority identity. The publisher's final edited version of this article is available at Arch Sex Behav.